I met with my oncologist on Friday the 13th after having blood work done this past Wednesday. My PSA was at 18.1, which is below 20, roughly my previous PSA. I was concerned that the Lupron might have failed and my PSA would be much higher, so we were pleasantly surprised with the results. On average, Lupron fails after about 2 years of use. I’m at about 2.5 years now. On the plus side, I’ve heard of one man where Lupron didn’t fail for 8 years. I guess that’s good news, but it’s hard for me to get excited about 5.5 more years of dealing with the side effects of Lupron. It’s not that I’m ungrateful that the drug was developed, I just don’t know if I can tolerate the side effects for that long.
I asked the oncologist what the effect of going off Lupron would be relative to my life expectancy. He was hesitant to provide a number, but finally did. His estimate was that Lupron could extend my life up to two years. That’s a big enough number that I have to find some way to cope with Lupron.
This last cycle with Lupron was particularly difficult. Instead of the first week being symptom free, the hot flashes started the day after the shot was administered and depression set in the day after that. Fortunately the depression was mild, but unwelcome none the less. As expected as the weeks went forward, the depressions became more intense. I had a TMS treatment during week four to help head off the depressions in weeks five and six, which historically have been the worst. The treatment was a failure for week five, but did help on week six. Usually weeks seven and eight are pretty benign, but that wasn’t the case this time. The depressions and hot flashes continued, albeit at a lower level.
I was scheduled to get another Lupron shot on Friday, but I think the oncologist took pity on me and delayed the shot for two weeks. I didn’t object. He shifted me from one month on and one month off to one month on and a month and a half off. I didn’t object.
There’s a “new” drug on the horizon, Xtandi, that will hopefully be approved before Lupron fails for me. It blocks testosterone, instead of reducing it. I’m hopeful that that may mean no depressions, but it’s not approved yet and it has a laundry list of other negative side effects. Still, I’ll watch it closely.